Berberine is a plant extract monomer with a wide range of pharmacological effects, including anti-inflammatory, antimicrobial, antiviral, anticancer, hypoglycemic, hypolipidemic, neuroprotective, and immunomodulatory properties. In this article, the inhibitory effects of berberine on mouse Lewis lung cancer cells, human non-small cell lung adenocarcinoma cells, human giant cell lung carcinoma cells, human large cell lung adenocarcinoma cells, and human squamous cell lung carcinoma cells are reviewed to give a detailed explanation of the pharmacological effect and mechanism of berberine against lung cancer and provide reference for its clinical development in lung cancer treatment.

Objective: To analyze the anti-infective treatment and pharmaceutical care process of a patient with Mycobacterium gordonae infection complicated with lung cancer, and provide reference for the clinical anti-infective treatment of such rare infectious diseases. Methods and Results: The patient was admitted for treatment due to persistent cough, expectoration and hemoptysis for more than two years. On the 11th day, next-generation sequencing results of the patient's alveolar lavage fluid indicated Mycobacterium gordonae, leading to the initiation of treatment with clarithromycin, rifampicin and moxifloxacin. However, two days later, the patient's bilirubin levels significantly increased. The clinical pharmacist identified this as liver damage caused by rifampicin and moxifloxacin, and recommended adjusting the treatment regimen to clarithromycin, linezolid and levofloxacin. After two days, the patient's bilirubin levels deceased to normal. During this period, a liquid-based thin-preparation cytologic test of the alveolar lavage fluid revealed atypical cells, suggesting non-small cell lung cancer. After anti-infective treatment for over three months, the patient's lung CT scan showed partial absorption and reduction of lung lesions, with near-complete absorption of bilateral pleural effusion. Considering the prolonged treatment course for non-tuberculous mycobacterial lung infection, the patient was advised to continue regular medication. Conclusion: Mycobacterium gordonae infection is relatively rare in clinical practice, so there is limited experience in clinical treatment of such cases. Clinical pharmacists should actively participate in the development of treatment regimens, monitor drug efficacy and medication safety, and ensure the effectiveness and safety of patient treatment.

Objective: To analyze the diagnosis and anti-infective treatment process of a patient with Chlamydia psittaci pneumonia, and provide reference for clinical diagnosis and anti-infective treatment of such atypical pneumonia. Methods and Results: The patient was admitted to Department of Respiratory and Critical Care Medicine due to fever and cough for 8 days. Infection indicators, including white blood cell count, neutrophil count, neutrophil percentage, and C-reactive protein, were significantly abnormal. Chest CT showed bilateral pulmonary inflammation. After admission, empiric treatment with Piperacillin-tazobactam sodium and moxifloxacin was initiated. Metagenomic next-generation sequencing of the patient's bronchoalveolar lavage identified Chlamydia psittaci. Considering the patient's history of pigeon contact, a diagnosis of Chlamydia psittaci pneumonia was made. As the therapeutic effect with moxifloxacin was unsatisfactory, the original anti-infection regimen was adjusted to omadacycline. One week later, the patient's symptoms and indicators basically returned to normal, and the patient was discharged after recovery. Conclusion: Chlamydia psittaci, as an atypical pathogen, is not easily detected by conventional pathogen detection methods. In such cases, new testing technologies like metagenomic next-generation sequencing can be considered. Clinically, treatment regimens should be adjusted based on the actual therapeutic effect of drugs to ensure effective therapeutic effect for patients.

Objective: To analyze the occurrence and treatment process of allergic shock induced by cefazolin in a patient with threatened premature labor and negative skin test, and provide reference for clinical medication safety of patients, particularly pregnant women. Methods and Results: :The patient (female, 26 years old) was hospitallized due to "36 weeks of gestation and 3 hours of vaginal leakage". The physical examination revealed fetal membrane rupture. To prevent infection with Streptococcus agalactiae, cefazolin was prophylactically administered (negative skin test). However, after intravenous infusion for 30 seconds, the patient developed symptoms of allergic shock, including numbness in hands and feet, chest tightness, shortness of breath, difficult breathing, vomiting, and cyanosis. Cefazolin was immediately discontinued, and emergency resuscitation was initiated. During this period, the fetal heart rate dropped from 110 beats per minute to 60-80 beats per minute, indicating fetal distress, and the cesarean section was performed immediately. Subsequently, the newborn and the mother were transferred to the pediatric department and ICU separately for further treatment. Several days later, both the newborn and the mother fully recovered and were discharged. Following the event, based on the evaluation criterion for adverse drug reaction association, the association between cefazolin and allergic shock was considered "highly likely". Conclusion: Although cefazolin is considered a relatively safe antibacterial drug and rarely causes severe adverse drug reactions like allergic shock, its medication risk remains. Therefore, clinical medication safety should be monitored, especially for special populations such as pregnant women, so as to ensure the medication safety for patients.

Objective: To analyze and compare the cardiac toxicity risks of anthracyclines such as doxorubicin, mitoxantrone, epirubicin, daunorubicin, and idarubicin based on real-world data, and provide reference for clinical medication safety of anthracyclines. Methods: Using the search terms "doxorubicin (L01DB01)", "mitoxantrone (L01DB07)", "epirubicin (L01DB03)", "daunorubicin (L01DB02)" and "idarubicin (L01DB06)", adverse drug events (ADEs) related to cardiac toxicity were retrieved from the USA FDA Adverse Event Reporting System (FAERS) database between January 2004 and September 2023, with the above five anthracyclines as primary suspected drugs, and the epidemiological characteristics of cardiac toxicity associated with these five anthracyclines were analyzed. Results: A total of 3 159 ADE reports involving cardiac toxicity for the five anthracyclines were found in the FAERS database, including 2 215 reports for doxorubicin, 265 for mitoxantrone, 422 for epirubicin, 197 for daunorubicin, and 60 for idarubicin. For 2 215 reports of doxorubicin, 2 392 ADEs were involved with cardiac toxicity, with 62 preferred terms (PTs); the top 3 pts in terms of the quantity of ADE items were cardiac toxicity (387 cases), heart failure (354 cases), and cardiomyopathy (311 cases). For 265 reports of mitoxantrone, 663 ADEs were involved with cardiac toxicity, with 32 PTs; the top 3 pts in terms of the quantity of ADE items were tachycardia (146 cases), cardiomyopathy (103 cases), and pericardial effusion (56 cases). For 422 reports of epirubicin, 367 ADEs were involved with cardiac toxicity, with 28 PTs; the top 3 pts in terms of the quantity of ADE items were heart failure (94 cases), cardiac toxicity (36 cases), and atrial fibrillation (29 cases). For 197 reports of daunorubicin, 257 ADEs were involved with cardiac toxicity, with 25 PTs; the top 3 pts in terms of the quantity of ADE items were heart failure (31 cases), tachycardia (27 cases), and atrial fibrillation (26 cases). For 60 reports of idarubicin, 67 ADEs were involved with cardiac toxicity, with 14 PTs; the top 3 pts in terms of the quantity of ADE items were heart failure (10 cases), myocarditis (9 cases), and cardiomyopathy (7 cases). Using the reporting odds ratio (ROR) method, analysis results revealed that for doxorubicin-related ADEs, PTs with ROR above 50 included cardiac toxicity, acute cardiomyopathy, and toxic cardiomyopathy; for mitoxantrone-related ADEs, PTs with ROR above 50 included myocardial hemorrhage; for epirubicin-related ADEs, PTs with ROR above 50 included right atrial dilation and myocardial edema; no PTs with ROR above 50 were found for daunorubicin-related ADEs; for idarubicin-related ADEs, PTs with ROR above 50 included left ventricular dilation. Seven cardiac toxicity related SMQ signals were detected in the Standardised MedDRA Query (SMQ) analysis, with cardiomyopathy and heart failure as common positive signals for all five anthracyclines. Conclusion: Cardiac toxicity caused by anthracyclines is commonly associated with cardiomyopathy and heart failure. The cardiac toxicity risk intensity varies among different anthracyclines. Clinically, drugs with a lower risk of cardiac toxicity should be prioritized, and careful monitoring of cardiac toxicity related ADEs should be implemented.

Objective: To analyze the clinical characteristics of adverse drug reactions (ADRs) in AIDS patients at a hospital, and provide reference for clinical medication safety of AIDS patients. Methods: ADR reports of 100 AIDS patients submitted from Anhui Provincial Hospital Infection District to the National Center for ADR Monitoring, China from 2019 to 2022 were selected as the research data. Information such as patient age, gender, drug name involved in ADRs, administration route, reason for drug use, occurrence time of ADR, clinical manifestation, severity, and clinical outcomes was collected to analyze the clinical characteristics of ADRs in AIDS patients. Results: Among 100 ADR reports, male patients were significantly more than female patients (90 cases vs. 10 cases), and the age group most affected was 40 to 59 years (54 cases, 54.00%). The majority of ADRs occurred within 3 days after medication (49 cases, 49.00%), followed by those occurred between 3 to 10 days after medication (33 cases, 33.00%). The administration route of drugs involved in ADRs were primarily intravenous infusion (49 cases, 49.00%) and oral administration (34 cases, 34.00%). The most drugs involved in ADRs were antibacterial drugs (47 cases, 47.00%), followed by antiviral drugs (17 cases, 17.00%) and antifungal drugs (11 cases, 11.00%). ADRs predominantly affected the digestive system (40 cases, 40.00%) and the nervous system (23 cases, 23.00%), followed by the hematologic system (15 cases, 15.00%) and the skin and appendages (12 cases, 12.00%). Among 100 ADRs, 98 cases were of "moderate" severity, while only 2 cases were classified as "severe". Among the patients, 74 recovered, 24 did not improve, and 1 case had an unclear outcome. Conclusion: Anti-infective drugs are the main drug type of ADRs in AIDS patients. Therefore, propaganda and education and medication monitoring of relevant drugs should be strengthened in clinical practice to ensure the medication safety of patients.

Objective: To identify substances with anti-Klebsiella pneumoniae activity based on multi-omics technology and validate them with molecular docking technology, and provide reference for the clinical development of drugs against Klebsiella pneumoniae. Methods: Whole-genome data of Klebsiella pneumoniae was obtained from the NCBI database. Data on human proteomes, bacterial essential proteomes, bacterial virulence factors, and drug molecules was collected from databases such as UniProt, DEG, VFDB, ChEMBL. A bacterial pan-genome analysis tool was used to analyze the pan-genome of Klebsiella pneumoniae. BLASTp tool was then used to screen out non-human homologous core proteins and identify potential drug targets. Active sites of proteins were predicted and drug molecules were optimized with related tools. Finally, batch molecular docking was conducted to validate the results and obtain the most promising active substances. Results: The pan-genomic analysis results showed that the genome of Klebsiella pneumoniae contained 3 454 core genes, 5 260 accessory genes, and 2 106 unique genes. The core genome of Klebsiella pneumoniae contained 2 608 essential proteins, 22 virulence factors, and 2 404 non-human homologous proteins. Through comparison of these three sets, 14 shared proteins were obtained, of which Gene2502 protein was considered as a potential target against Klebsiella pneumoniae. Molecular docking was performed with Gene2502 protein as the receptor, in the top nine compounds with the strongest docking scores, paromomycin was identified with antibacterial activity and may be a potential compound against Klebsiella pneumoniae. Conclusion: Multi-omics technology and molecular docking technology provide new ideas for screening and designing substances with anti-Klebsiella pneumoniae activity.

Objective: To analyze the diagnosis and treatment process of a patient with insulin autoimmune syndrome (IAS) induced by propylthiouracil (PTU), and provide reference for the clinical diagnosis and treatment of IAS. Methods and Results: The patient was admitted for treatment due to hyperthyroidism and hypoglycemia. Upon further examination, the patient was tested positive for insulin antibody, with an insulin level greater than 1 000 μIU/mL. IAS was suspected, and PTU was discontinued. Two days later, oral glucose tolerance test and C-peptide and insulin tests were conducted. It was found that during hypoglycemia, both insulin and C-peptide levels were elevated, and the increase in insulin and C-peptide levels was significantly mismatched, confirming the diagnosis of IAS. Given that hypoglycemic episodes occurred after PTU administration and not before, it was considered that IAS was induced by PTU. The patient was instructed to continue discontinuing PTU and was prescribed oral prednisone acetate, along with adjustment of the diet to smaller, more frequent meals. One week later, the patient no longer experienced hypoglycemia, and follow-up after one year showed that blood glucose and insulin antibody levels were normal, with insulin levels only slightly elevated on one occasion. Conclusion: IAS is a rare disease, indicators such as blood glucose, insulin, C-peptide, insulin antibody, and drug induced factors should be comprehensively considered for its diagnosis. Targeted treatment based on accurate diagnosis is essential for effective and safe treatment of patients.